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'Practice meltdown' biggest cause of GP mental health problems

‘Practice meltdown’ is the biggest driver for GP’s seeking help with mental health issues, according to Professor Clare Gerada, London GP and NHS Practitioner Health Programme (PHP) medical director.

Anxiety, depression and post-traumatic stress disorder are the most common conditions seen by the PHP, which was rolled out nationally earlier this year with NHS England funding.

Professor Gerada said that a variety of different circumstances could lead to ‘practice meltdown’ but the situation was driven by GPs having their workload suddenly multiply due to circumstances beyond their control.

She said: ‘It could be that one or two of the older GPs have retired, one might be on maternity leave or long term sick leave and that’s left two doctors usually in their mid-forties trying to hold a practice of 8-12,000.

And guess what? They suffer, because what they do to try and hold it all together is work harder and harder and harder. They go in at weekends, they go in after hours, they do 14-15 hour days.

'They might approach NHS England which will say you can’t close your list. And then something happens, one of those two doctors can’t get the locums, shouts at a receptionist or just sits in front of a computer and cries.’ 

Professor Gerada said that the service had seen a high uptake since it launched earlier this year.

She said: ‘I always anticipated we would see large numbers but even I have been surprised by the demand. in the first four weeks we saw 20% of what we have been commissioned to see in a year.’

GPs who have used the services of the PHP include those facing stress due to CQC inspections, young locum GPs and GPs dealing with life events or addictions.

Readers' comments (7)

  • If GPs were employees of NHSE it would have a duty of care. Because they are self employed contractors it appears that NHSE is completely unsympathetic to the plight of Practices in difficulties of this sort. I left my practice as a partner at the end of 2014 because I could see an impending meltdown and did not wish to be the last man standing. NHSE was not helpful. I go further to say that I felt that they were allowing practices to fail. In my view it is time that GP partnerships were allowed to be limited liability partnerships. It is wrong that people who are doing their best for the NHS and their patients face personal financial ruin through no fault of their own

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  • I know

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  • Simon - have you considered writing about your experiences for Pulse? I think we have a lot to learn from them.

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  • Sadly, the morally "criminal" actions of DOH and NHS England in "thuggery" is making medicine unsafe nowadays.

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  • Dr David Barrett

    If you are swimming with Sharks eventually you have to get out......

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  • No one has a duty of care to doctors. How come I, like thousands have done 80+ hours without sleep?
    This single issue would take Medicine to a fair level.
    Define safe working first and everything else will follow.
    And I think the BMA should define this for ALL specialties. Then the abuse of doctors by the DOH will stop.

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  • I know too.
    There is the chance at appraisal to look at a doctor's mental and physical health and then be proactive about change - rather than waiting for implosion. Appraisal focuses on minor things and avoids addressing the important issues. It could be MUCH more supportive.
    Believing that it would be best for you and everyone you know if you were dead was pretty grim.
    Keep up the good work Clare.

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